Q.1 Which is the most common congenital heart disease in children?
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
Tetralogy of Fallot
Explanation - Ventricular septal defect (VSD) is the most common congenital heart disease, accounting for nearly 25-30% of cases.
Correct answer is: Ventricular septal defect
Q.2 Which murmur is typically associated with patent ductus arteriosus (PDA)?
Ejection systolic murmur
Diastolic murmur
Continuous machinery murmur
Mid-systolic click
Explanation - PDA produces a continuous 'machinery-like' murmur due to persistent flow from the aorta to the pulmonary artery.
Correct answer is: Continuous machinery murmur
Q.3 Cyanosis at birth that improves with crying is most commonly seen in:
Choanal atresia
Tetralogy of Fallot
Transposition of great arteries
Tricuspid atresia
Explanation - In bilateral choanal atresia, neonates develop cyanosis which improves when they cry, as they breathe through the mouth.
Correct answer is: Choanal atresia
Q.4 Which of the following is NOT a component of Tetralogy of Fallot?
Ventricular septal defect
Pulmonary stenosis
Overriding aorta
Left ventricular hypertrophy
Explanation - Tetralogy of Fallot is characterized by VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.
Correct answer is: Left ventricular hypertrophy
Q.5 What is the drug of choice to maintain ductal patency in duct-dependent congenital heart disease?
Propranolol
Furosemide
Prostaglandin E1
Digoxin
Explanation - Prostaglandin E1 infusion is used to maintain ductus arteriosus patency in duct-dependent congenital cardiac lesions.
Correct answer is: Prostaglandin E1
Q.6 Which congenital heart disease is associated with Turner syndrome?
Aortic stenosis
Coarctation of aorta
Mitral stenosis
Tetralogy of Fallot
Explanation - Turner syndrome is strongly associated with coarctation of the aorta and bicuspid aortic valve.
Correct answer is: Coarctation of aorta
Q.7 The 'egg on a string' appearance on chest X-ray is seen in:
Transposition of great arteries
Tricuspid atresia
Total anomalous pulmonary venous connection
Ebstein’s anomaly
Explanation - The 'egg on a string' appearance is typical of transposition of the great arteries due to narrow mediastinum and enlarged cardiac silhouette.
Correct answer is: Transposition of great arteries
Q.8 Which heart sound is commonly associated with atrial septal defect?
Wide fixed splitting of S2
Ejection systolic click
Loud S1
Mid-diastolic opening snap
Explanation - ASD causes wide and fixed splitting of the second heart sound due to prolonged right ventricular systole.
Correct answer is: Wide fixed splitting of S2
Q.9 Which congenital cyanotic heart disease is the most common?
Tricuspid atresia
Tetralogy of Fallot
Pulmonary atresia
Hypoplastic left heart syndrome
Explanation - Tetralogy of Fallot is the most common cyanotic congenital heart disease beyond infancy.
Correct answer is: Tetralogy of Fallot
Q.10 Which genetic syndrome is most commonly associated with atrioventricular septal defect?
Turner syndrome
Down syndrome
Marfan syndrome
Klinefelter syndrome
Explanation - Atrioventricular septal defect (endocardial cushion defect) is strongly associated with Down syndrome (Trisomy 21).
Correct answer is: Down syndrome
Q.11 Rib notching on chest X-ray is a classic feature of:
Aortic stenosis
Coarctation of aorta
Tetralogy of Fallot
Patent ductus arteriosus
Explanation - Rib notching is due to collateral circulation via intercostal arteries in coarctation of the aorta.
Correct answer is: Coarctation of aorta
Q.12 In Eisenmenger’s syndrome, the initial cardiac lesion is usually:
Aortic stenosis
Ventricular septal defect
Coarctation of aorta
Pulmonary stenosis
Explanation - Eisenmenger’s syndrome results from long-standing left-to-right shunt, commonly due to VSD, leading to pulmonary hypertension and reversal of shunt.
Correct answer is: Ventricular septal defect
Q.13 Which drug is contraindicated in Wolff-Parkinson-White syndrome?
Adenosine
Amiodarone
Propranolol
Digoxin
Explanation - Digoxin increases conduction through the accessory pathway in WPW syndrome and may precipitate ventricular fibrillation.
Correct answer is: Digoxin
Q.14 Which congenital heart disease presents with 'boot-shaped' heart on X-ray?
Tetralogy of Fallot
Patent ductus arteriosus
Ventricular septal defect
Ebstein’s anomaly
Explanation - Tetralogy of Fallot produces a boot-shaped heart due to right ventricular hypertrophy.
Correct answer is: Tetralogy of Fallot
Q.15 Which murmur is heard in hypertrophic obstructive cardiomyopathy?
Continuous murmur
Ejection systolic murmur at left sternal border
Mid-diastolic murmur
Holosystolic murmur at apex
Explanation - Hypertrophic obstructive cardiomyopathy produces an ejection systolic murmur best heard at left sternal border.
Correct answer is: Ejection systolic murmur at left sternal border
Q.16 What is the most common cause of acquired heart disease in children in developed countries?
Rheumatic fever
Kawasaki disease
Infective endocarditis
Viral myocarditis
Explanation - Kawasaki disease is the leading cause of acquired heart disease in children in developed countries.
Correct answer is: Kawasaki disease
Q.17 Which of the following is NOT a feature of Kawasaki disease?
Conjunctival injection
Strawberry tongue
Cervical lymphadenopathy
Splenomegaly
Explanation - Splenomegaly is not a feature of Kawasaki disease. Classical features include conjunctival injection, strawberry tongue, rash, and lymphadenopathy.
Correct answer is: Splenomegaly
Q.18 Which investigation is the gold standard for diagnosing coarctation of aorta?
Chest X-ray
Echocardiography
Cardiac catheterization
CT angiography
Explanation - Although echocardiography is used for diagnosis, cardiac catheterization remains the gold standard for anatomical and hemodynamic assessment.
Correct answer is: Cardiac catheterization
Q.19 Which heart lesion is most likely to cause paradoxical embolism?
Patent foramen ovale
Aortic stenosis
Mitral regurgitation
Pulmonic stenosis
Explanation - Patent foramen ovale allows right-to-left shunt, enabling paradoxical embolism.
Correct answer is: Patent foramen ovale
Q.20 Which of the following is a late complication of Kawasaki disease?
Coronary artery aneurysm
Atrial fibrillation
Pulmonary embolism
Aortic stenosis
Explanation - The most serious late complication of Kawasaki disease is the development of coronary artery aneurysms.
Correct answer is: Coronary artery aneurysm
Q.21 Which of the following is a cyanotic heart disease?
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
Tricuspid atresia
Explanation - Tricuspid atresia results in cyanosis due to absence of direct communication between right atrium and right ventricle.
Correct answer is: Tricuspid atresia
Q.22 Which sign is typical of severe aortic stenosis in children?
Wide pulse pressure
Parvus et tardus pulse
Bounding pulse
Collapsing pulse
Explanation - Severe aortic stenosis produces low amplitude and delayed carotid upstroke known as parvus et tardus pulse.
Correct answer is: Parvus et tardus pulse
Q.23 Which heart lesion is associated with maternal diabetes mellitus?
Ventricular septal defect
Transposition of great arteries
Coarctation of aorta
Aortic stenosis
Explanation - Infants of diabetic mothers have a higher risk of developing transposition of the great arteries.
Correct answer is: Transposition of great arteries
Q.24 The Ross procedure is a surgical technique used in:
Tetralogy of Fallot repair
Aortic valve replacement
Mitral valve repair
Closure of PDA
Explanation - The Ross procedure involves replacing a diseased aortic valve with the patient's own pulmonary valve.
Correct answer is: Aortic valve replacement
Q.25 Which clinical feature is typical of supraventricular tachycardia in children?
Irregularly irregular pulse
Sudden onset of palpitations
Bradycardia
Wide QRS complex tachycardia
Explanation - Children with supraventricular tachycardia present with abrupt onset palpitations, tachycardia, and sometimes syncope.
Correct answer is: Sudden onset of palpitations